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Head And Neck > Paediatric Otorhinolaryngology > Flashcards

Paediatric Otorhinolaryngology Flashcards

1
Q

How do ontological disease present?

A

Hearing loss
Discharging ear
Ear ache
Tinnitus
Vertigo

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2
Q

What are things to consider for a child with hearing loss?

A

Congenital vs acquired
Unilateral vs bilateral
Conductive vs sensorineural

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3
Q

What is could be in a history in a child with hearing loss?

A

Ear symptoms
-pain
-discharge
-loss of function- hearing loss, dizziness, tinnitus
Speech development, school performance lacking
Behavioural problems
Maternal perinatal infection
Delivery issues
Neonatal infections, drugs, jaundice
Growth, immunisations, passive smoking, breast vs bottle feeding

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4
Q

Assessments should be done of children and of what age?

A

6-18 moths= distraction test
12 months- 3 years= visual reinforced audiometry
3-5 years= play audiometry
4 years += pure tone audiometry

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5
Q

What are objective assessment of auditory system?

A

Otoacoustic emissions
Auditory brain stem responses
Typmanometry

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6
Q

How common is otitis media in children?

A

80% before 10YR

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7
Q

At what ages is otitis media most common?

A

2yr and 5yr

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8
Q

What are the riskfactors for otitis media?

A

Day care
Smoking
Cleft palate
Down syndrome

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9
Q

How is otitis media with effusion treated?

A

Most clear by themselves
Treat with hearing aids or grommets and adenoidectomy

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10
Q

What are symptoms of otitis media with effusion?

A

Hearing loss
Speech delay
Behavioural problems
Academic decline
(Imbalance)

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11
Q

What are signs of otitis media w/ effusion?

A

Dull TM
Fluid level
Bubbles

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12
Q

What is the aetiology of otitis media w/ effusion?

A

Eustachian tube dysfunction
- anatomy of skull base
-muscular immaturity
Adenoidal hypertrophy
Resolving AOM

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13
Q

Treatment of otitis media with effusion?

A

Auto inflation
Grommet

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14
Q

What do you need to do in a child with painful/ discharging ear?

A

History
Examination
Investigation

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15
Q

What is the treatment for otitis externa?

A

Aural micro suction
Topical antibiotics
Water precaution

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16
Q

What is the typical history in acute otitis media?

A

Short history
Pain
Fever
Discharge

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17
Q

What is the microbiology of acute otitis media?

A

Haemophilus influenza
Strep pneumonia
Moraxella catarrhalis

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18
Q

How do you treat acute otitis media?

A

Treat with antibiotics
Grommets + adenoidectomy if recurrent

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19
Q

What is a complication of acute otitis media?

A

Brain abscess

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20
Q

When should you suspect chronic otitis media/ cholesteatoma?

A

In children w/
Chronic discharging ear
Hearing loss despite grommets

21
Q

What is the treatment of chronic otitis media, cholesteatoma

A

Mastoidectomy

22
Q

When does the ethmoidal and maxillary sinuses fully develop?

A

0-4 months

23
Q

When does the sphenoid sinus fully develop?

A

3-7yr

24
Q

When does the frontal sinus fully develop?

A

8yr - adolescent

25
Q

What is the typical history of a child with a blocked/runny nose?

A

Nasal symptoms
-pain
-discharge
-loss of function - blocked nose, sense of smell
History of foreign body
Feeding
Snoring, quality of sleep

26
Q

What do you need to distinguish with rhinitis?

A

Allergic vs non-allergic

27
Q

What should you investigate in rhinitis?

A

Allergen test (IgE)

28
Q

What is the treatment in rhinitis?

A

Nasal douching
Antihistamines
Nasal steroids

29
Q

What should you check for in large adenoids?

A

Check for sleep apnoea

30
Q

What does a nasal foreign body tend to be?

A

Unilateral

31
Q

What does a nasal foreign body need?

A

Needs EUA

32
Q

What does sinusitis and polyps have overlapping symptoms with?

A

Rhinitis/ large adenoids

33
Q

What is sinusitis and nasal polyps associated with?

A

Cystic fibrosis

34
Q

What can be a complication of sinusitis and polyps?

A

Orbital cellulitis

35
Q

What is orbital cellulitis?

A

Sinusitis of ethmoid cells
Swollen eyes

36
Q

What does bilateral chonanal atresia do?

A

Manifest as unable to breathe

37
Q

Who is epitaxis more common in?

A

Males over females

38
Q

What should be considered in epitaxis?

A

Coagulpathy
Haematological abnormality

39
Q

What is littles area?

A

Lots of little arteries come together

40
Q

What is the management of epitaxis?

A

Appropriate 1st aid
Antibiotic treatment (naseptin, bactroban)
Cautery (silver nitrate under LA, diathermy under GA)
Nasal packing

41
Q

What is a typical history of a child with a sore throat?

A

Throat symptoms
-pain(odonophagia, ear ache)
-discharge (cough)
- loss of function (dysphagia, breathing problems, hoarse voice)
Snoring, drooling

42
Q

Where should you exam with a sore throat?

A

Throat
Neck
Ears and nose

43
Q

What can tonsillitis be caused by?

A

Bacterial (B haem or strep B)
Viral (EBV)

44
Q

What is there a risk of in tonsilitis?

A

Glomerulonephritis

45
Q

What is the treatment of tonsilitis?

A

Supportive
Antibiotics

46
Q

What can be a complication of tonsillitis?

A

Peritonsillar abscess

47
Q

What could be the anatomy and physiology of a child with airway issues?

A

Large tongue
Large tonsils
Large epiglottis
Short neck
Subglottis narrowest

48
Q

What is the typical history of a child with airway issues?

A

Usually an emergency
Hx of foreign body
Recent illness
Feeding problems
Stridor - inspiratory

49
Q

What could be pathology behind neck lumps?

A

Thyroglossal duct cyst
Brachial cyst
Cystic hygroma
Cervical lymphadenopathy

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